Individual
KYLIE ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6 MARION PT, PEKIN, IL 61554-9416
(907) 980-2512
Mailing address
6 MARION PT, PEKIN, IL 61554-9416
(907) 980-2512
Taxonomy
Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
041367713
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209028165
IL
Other
Enumeration date
03/03/2022
Last updated
09/22/2023
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